Met with the oncologist today. My PSA was up about 10% into the mid 30s. He told me that means the Lupron is slowly failing, which is good. He wants to keep me on Lupron (and Casodex) until the month to month jumps hit 20% or my PSA exceeds 50.

At that time we’ll add Zytiga to the regimen and drop the casodex. I thought that I’d be done with Lupron, but that’s not the case. I’ll still get Lupron every month.

I’m a little concerned about going off the casodex, since I feel it was a major factor in controlling the depression. He thinks I just got used to the Lupron. At any rate, if the depression returns, I’ll propose we add casodex back to the mix and see what happens.

I also asked about travel next year, specifically in about seven months. He said there shouldn’t be any problems making the trip, good news!

I’ve started to come to terms with my death likely in under two years. The panic attacks are largely gone and the anxiety is much ore manageable. Interestingly enough, the anxiety and panic is almost always the worst right before I go to sleep. I think I just don’t want the day to end and to officially one day closer to death, but who knows.

After my last post I decided I needed to post the next time I felt really good. Fortunately, it wasn’t that long. The last week has been very typical of the end of the Lupron effect for me. Sunday and Monday were absolutely terrible, then suddenly Wednesday and Thursday were quite good, at least in the evenings. That seems to be a recurring theme, Pre-evening is iffy and the evenings are much better. Today, Thursday, I wound up taking Xanax to help me sleep through the afternoon, and awoke to a really good evening.

Despite my cancer I feel incredibly lucky. I managed to live the American dream. After my father’s death when I was 7, my mother and I were thrown into financial chaos. For over ten years we lived below the poverty line, although I didn’t know it t the time. It was just the way life was as far as I was concerned. At one point it looked like we’d have to move into government housing, the projects, but my grandmother had some land with timber on it that a company wanted to buy and it saved us, as well as, providing funds for my college education (supplemented by numerous loans from the University). I graduated, got a great job at Texas Instruments and moved up the corporate ladder. Eventually, I married and my wife and I started a software business that served the Department of Defense and the National Cancer Institute. We were able to retire early with enough money to live comfortably. As I said, I have been incredibly lucky.

As I was transitioning into retirement, The Stage I cancer diagnosis came. By the time I was almost fully retired, the Stage IV diagnosis came. It’s now almost 2.5 years later. We’ve traveled a lot, bucket list kinds of trips, but Lupron has been a consistent problem. Timing trips so I’m not affected by Lupron has been pretty much impossible.

I don’t know what to do about Lupron. On the one hand, it is unquestionably extending my life, but we don’t know by how much. On the other hand, I feel horrible 25-50% of the time. The depressions are often so bad that I pray for a brain aneurism to end it all.

Enough history, right now I feel great. The Lupron has subsided and a cocktail or two tonight has enhanced my view of life that much more.

I want to thank all my followers for your support. Your likes, comments, and encouragement mean the world to me. I suspect that one of the reasons I’m more inclined to post when I’m under Lupron’s spell is to get your support. It helps so much in helping me to get past the low points.

The future. It scares me. At this point it’s mostly fear of the pain that is waiting for me. The docs tell me that there are very powerful painkillers and I’ll be OK, but I still have my doubts. I take comfort in knowing that there is an option to put me in a chemically induced coma until I die. If the painkillers fail, that’s what I want.

I haven’t gotten to the point where I am scared about being dead. I may not get there at all, but I’ll certainly be more apprehensive at the very minimum. I’ve been reading the books about people who “died” and were brought back to life in the hospital. There are so many cases of this I find it hard to brush off. It also helps that I really like the experiences they report. I figure if this doesn’t happen, then when I die that’s it.

Saw the oncologist today. It’s been three months since my last Lupron shot. At one month after, my PSA was about 4. It’s now at 28 – higher than I’d like, but not too bad. I was slated to get my next Lupron shot today, but we decided to delay it. We have a cruise coming up and don’t want it to fall during the 5th or 6th week after the shot.

We talked about how much life extension the Lupron is providing for me. He said it varies from person to person and can be months to a year or more. In my case my PSA still drops quite low when I go on Lupron, so he guesses the life extension for me is on the longer side.

We talked about my lymph node that was so enflamed. He did a physical exam and didn’t find anything unusual. So we’re just going to assume everything is OK.

The pills the GI gave me seem to be doing the trick. My stomach problems are getting better. I’m now able to eat and drink pretty much anything I want. It’s a nice change from a bland diet and water.

It’s been nearly two months since my last post, altogether too long. Oddly enough, many of the cancer blogs I follow are in the same situation. Seems many of us these last few weeks haven’t been writing.

For me it’s been a collection of things, getting used to a new normal, traveling, and then getting a pretty severe case of bronchitis.

My new normal is something like this, get a Lupron shot, have mild effects (hot flashes, chills) for a couple weeks, follow that with a couple weeks where mild depression and nausea is added, then cap it off with a couple weeks of significant depression in the early part of the day, transforming to anxiety later in the day and more nausea. I then have a few weeks of respite before the next shot.

Fortunately, my GP and oncologist both suggested I take Prilosec as a prophylactic for the nausea and it’s worked great. Xanax has also been a big help with the afternoon anxiety attacks. By the evening I’m usually fine. I probably should give some credit to the Gin and Tonics for that!

I hesitated to call this post the new normal, because I have no idea how long it will stay this way. Lupron fails on average about two years after it’s started. I’m getting dangerously close to the two year mark. At this point I’m just choosing to believe the Lupron will work significantly longer for me than it usually does. There’s no statistical evidence to indicate I can’t be one of the exceptions, so what the Hell. When it does fail, it’s off to the next step.

In the meantime my life has been pretty full. We took about a 2 week cruise of the British Isles and had a great time. Photos will be posted eventually on my sister blog, Jim’s Pic of the Day. In the meantime there a are posts from various zoos, etc. that I’ve visited over the years. Unfortunately on the last day of the cruise I developed a nasty case of bronchitis. It suspended updates for “pick of the day” and this blog temporarily, but I’m over it now.

Sometimes I wonder what folks who follow this blog wonder about me. One question stands out in my mind, especially among the folks who have known me for decades. Did I always have this much trouble with depression and anxiety? Did I just do a great job of hiding it? The short answer is no.

I’ve had problems with depression and anxiety on a limited basis throughout my life, but for most of my life it wasn’t particularly serious. In fact, it wasn’t until I was in my mid-forties when I first started taking antidepressants and even then I was on and off them.

In 2008, right around the time I was first diagnosed with phase I cancer, my depressions got worse – no big surprise.

In late 2008/early 2009 I had brachytherapy and conformal external beam radiation to kill my prostate and my cancer. I was given an 80% chance of being cancer free at the five year mark, which would be early 2014. Cancer free doesn’t mean you’re cured, it just means there’s no detectable sign of the cancer at a given point in time. In other words you’re going to be tested for the rest of your life. For prostate cancer that meant PSA tests about every six months. I decided I was going to bull through it and everything would be OK. The depressions had little to do with the cancer as far as I was concerned.

Reality was telling a different story. Before long I was officially declared “treatment resistant”, meaning I didn’t respond well to single or multiple anti-depressant cocktails.

About a week before each test my anxiety would start gradually increasing to a crescendo before the test results came back. It became very clear that the disease, which I supposedly, probably defeated, was in fact seriously messing with my quality of life every six months. I thought about ending the testing and letting nature take its course. The doctors talked me out of it. I know now that was a mistake, I should have stopped getting tested, but I can’t change it at this point.

In late 2011 my PSA reading was slightly elevated, we did a bone scan, found some spots on my spine, and that graduated me to a phase IV cancer diagnosis. The only good news is we caught it super early. Even so there’s no hope for remission. All that can be done for prostate cancer is to slow it down. Depression and anxiety-wise I was very lucky that I was just about to start on a new anti-depressant cocktail that worked very well for a month or so. I definitely needed the help.

In January 2012, although I didn’t know it at the time, I was about to make the biggest mistake of my life. The doctors were split on whether I should take an aggressive route and irradiate the spots or follow the standard of care and wait for it to get worse. I was told that if I irradiated, the worst side effect would be mild fatigue. So I decided to go ahead with the radiation. They were terribly wrong, and as I mentioned in the last post, it wound up being a horrible error. If you look carefully at my posts over time, the worst depressions started after February.

I find myself reliving my past a lot more since the stage IV diagnosis. Maybe people’s lives really do flash before them when they’re about die and when they know they’re dying “soon” the process starts and runs more slowly. I’m also spending some serious time getting my photographic legacy in order for my wife. But this isn’t all about the past. There’s still lots of time, even if it’s only a few years, to create a lot of great memories.

I’m always trying to find ways to better capture and preserve these memories. An up and coming technology called Life Logging may play a significant role. The idea is simple. You wear a tiny camera that takes wide angle photos “every so often” of what’s in front of you. Later these are edited and assembled into short time lapse movies of what you saw. Or you place the unit somewhere overlooking the area where you want to preserve the action. It sounds perfect to me for bucket list adventures, major family events, etc. Some may even want to wear one almost all the time.

The underlying technology to do this has been around for a long time, but only recently have startup companies started working on Life Loggers for the mass market. Two products are close to being released. The first, Autographer, is currently slated for availability in the UK in late January, 2013, for an estimated price of around 400 English Pounds (about $650 US), as of this writing. It’s by far the more sophisticated of the two and goes to great lengths to decide when the best time is to take pictures. It’s got five sensors and GPS to identify when to take a photo, based on changes in light, color, motion, direction, and temperature. For example; Autographer might capture an image when the wearer speeds up as they run for the bus, moves from a warm pub to a snowy street, or turns around to greet a friend. Photos are uploaded to your computer and you make one or more videos using their software. There’s a pretty good video on their site introducing the camera. Financially, Autographer has the advantage that even though it’s a startup, it has a well established British company behind it. (Thanks to Gizmodo.com for an interview they scored with the developers, which provided some of the info here.)

The second product is Memonto. It’s slated for availability in April 2013 at a cost of $279 US, as of this writing. It takes a picture every 30 seconds, period. This isn’t necessarily bad. It’s unclear if Autographer’s approach to snapping shots based on a collection of sensors is worth the extra cost compared to simple fixed interval shots. Photos in Memonto are uploaded to a protected web site Memonto hosts where they are geotagged and their computers take an automated first cut at editing the shots into multiple photo streams called “moments”. The user can then re-edit as they please. There’s a documentary on life logging on their site. If you scroll past the halfway point, a large number of photos from a prototype device are shown (at least I assume that’s what they are). They have a pronounced yellow cast. Hopefully, this will be removed in the final product and is not considered an “Instagram filter” look that’s desirable. The company is crowd-source funded through Kickstarter.

Both products have batteries that they claim will last at day or two before recharging. They also both claim they’ll have very easy to use software to edit and build the movies. Assuming the cost is reasonable, the software is where the rub will likely be, if there is one (or two). The hardware development needed is more evolutionary than revolutionary. The opposite is true for the software. Based on what little information there is about the companies, it’s hard to tell which one is more likely to produce the best software.

Between the two, based solely on the hardware and workflow, I prefer Autographer’s approach. I believe having a collection of sensors decide when to take the shot will result in picture streams that are smaller, more relevant, and need less editing. I also greatly prefer that all Autographer’s pictures will be stored and edited on my local computer instead of requiring an upload to Memonto’s cloud computers to get GPS tagged and edited into moments.

Stay tuned. If the initial reviews are good for either product, I’ll probably give ’em a try.

We’re back from vacation! We were overseas for almost three weeks. We’ve decided that’s a little too long. It also exposed us to too many cooties on board. Our foursome is now all recovering from moderately severe chest colds. Still, we had a great time.

A few notes from the trip. The top two locations visited: La Sagrada Familia and the Leaning Tower of Pisa. La Sagrada Familia is a Gaudi designed church in Barcelona, Spain. Construction started in 1882 and they hope to complete it in 2025, the centennial of Gaudi’s death. It’s interior is finished and is open to tourists. Photographs are permitted. Without question, this is the most incredible, awe-inducing structure of any kind I’ve ever seen. Before this trip, I had no idea it even existed.

I almost passed on the trip to see the Leaning Tower of Pisa. After all, I’d seen many, many pictures of it starting back in grade school. It’s a skinny tower they built in the wrong place and it started leaning. I never understood why they didn’t jail the architect, bulldoze the tower, and start over. All I can say is there is something magical about the Tower when you see it right in front of you. I took dozens of shots from all different angles and distances to get just the right shot. It was surprisingly difficult to capture what the Tower felt like to me in one picture. To anyone else, that shot will look like just another shot of the Tower, but to me it is the Tower.

As is typical on cruises, the internet access was spotty at best and outrageously expensive. We’re glad to be back in the US and have fast, cheap, reliable access.

I confirmed that jet lag does indeed screw up my system something fierce. I again had anxiety attacks in the mornings, this time the worst I’ve ever had. My wife was great helping me through this. I don’t know what I would have done without her. Oddly enough, by the afternoon, the anxiety was always gone. Part of the problem, I’m pretty sure, is my most recent cocktail is a bit of a step back. TMS in late December/early January is looking more and more likely.

I didn’t have to deal with jet lag on the way back thankfully – ours was a repositioning cruise for the cruise line, so it was transatlantic at the end. When we docked in Fort Lauderdale, Florida we were only an hour off our home time zone!

Stay tuned to Jim’s Pic of the Day for shots of La Sagrada Familia, the Leaning Tower of Pisa, and many others. Note it may be a week or so before they start appearing.